Does in make a difference if your employer is Plan Adm. and Plan Fiduc

[Guest lindy]

Somehow I just recently found out that my employer (was) the Plan Adm. and Plan Fiduciary for my LTD plan.

In a mediation/court proceedings does this mean anything to me or the settlement it self? As opposed to the LTD Ins. company beng the Plan adm and Fiduciary?

Just curious of any differences, good , bad, or whatever ?

I also found a Major decrepancy (spelling?) from their Summary Plan Paperwork vs. what they give out to employees regarding their LTD benefits... From everything I have read it looks like they say that what is in their Plan Summary at the home office is what stands up and not the booklet given to employees. Is that correct?

[jeanine]

Which language prevails is up to the court. Some courts take the view that what you have given to the enrollee is what matters, despite whatever your documents claim.

[Moe Howard]

What exactly do you mean by "Plan Fiduciary" ? A welfare benefit plan may have several different types of fiduciaries (each having a different function).

You seem to be concerned about your employer being the one who will sit in judgement to approve or deny the disability claims of its employees.

The plan document will state who the "Claims Fiduciary" is. The claim fiduciary is usually the insurance company (when the plan is fully insured) and usually the employer (when the plan is self-insured ...which is rare).

It will be to your employer's advantage for employees not to receive LTD benefits... if it results in the employer having to pay something (such as continued premiums). I suggest that you find out who has to pay the continued premiums once an employee begins drawing LTD. (There may be no premium charge if the LTD policy is the kind in which future premiums are waived once LTD coverage begins).

It will always be advantageous to the insurance company to deny disability claims (no matter if premiums are required or not).

Since the plan has informed you that the plan policy prevails over the booklet that you were given, then the employer is protected. However, a federal court could decide differently -- depending on the facts and circumstances of the difference between the plan policy and the booklet.

If I were you, I would educate myself about the plan and obtain all the documents that the plan administrator is legally required to give you. (Namely: Summary Plan Description, Summary Annual Report and a copy of the policy).

[Guest lindy]

Moe,

You've given me a lot of good information. It is sincerely appreciated. Yes, I have gone over 5 different plans (including those you mentioned, ie SUmmary etc.) they ALL have different phrases etc. That is why I couldn't understand it, nor could other tax pro's I sought out. So, as I mentioned, I have found a tax attorney who does this kind of thing and knows what on earth is going on.

I am very tired of looking at everything and not being a Pro it is hard to ascertain the particular laws/rules etc. when things differ so greatly.

Anyway...onward and Thanks again.